Female Genital II Flashcards
(51 cards)
Day 1-4 in female cycle is what? 4-14? 15-27? 28?
- Menses
- Proliferative Phase
- Secretory Phase
- Collapse
What hormone is being produced in the proliferative phase?
Only estrogen
What type of endometrium has small regular glands that are evenly spaced and gland stroma ratio is 1:1?
proliferative endometrium
[the glands are not very squiggly yet]
What event does the secretory phase follow? what happens to the stroma during this phase?
- Ovulation and subsequent progesterone secretions
2. decidualizes in preparation of implantation
What happens if there is no implantation?
endometrium sheds (menses) and the cycle repeats
T-F– significant pathologic disease in the uterus will cause obvious abnormality on clinical exam?
False0 often does not
T-F– the uterine lining changes daily in a reproductive age woman
True
What are 3 common systemic causes of abnormal vaginal bleeding?
- von Hillebrand
- thrombocytopenia
- Thyroid disorders
What is anovulatory dysfunctional uterine bleeding?
disturbed hypothalamic pituitary ovarian axis
What is ovulatory dysfunctional uterine bleeding referring to?
Normal HPO axis but increased menstrual flow
What are the 4 common clinical management techniques of abnormal bleeding?
- History and exam
- labs- HCG, thyroid
- Transvaginal US
- Endometrial Biopsy
What are endometrial polyps thought to be related to? where are they most common? what are the three key features?
- hyperestrogenism
- Fundus
- Fibrous stroma, dilated endometrial glands, thick walled vessels
What are the 2 types of endometrial hyperplasia?
simple and complex
What is the low power architecture of simple endometrial hyperplasia?
1:1 glands:stroma and some irregular/branched glands
What is the low power architecture of complex endometrial hyperplasia?
> 1:1 glands:stroma, more irregularly shaped glands with many branches and offshoots
What is the number 1 parameter in determining whether hyperplasia might progress to adenocarcinoma?
Atypia
- Fewer than 3% without progress to adenocarcinoma
- 29% with progress to cancer
What is the 2nd step in evaluation of hyperplasia?
describe cytomorphology of cells
When there is no atypia what do the glandular cells look like? what is the only thing that is altered?
- similar of normal proliferative endometrium
2. Only the architecture of the glands is altered
Atypia in hyperplasia has what 2 major things can be visualized?
- loss of polarity of the glandular cells
2. rounding up of nuclei, vesicular chromatin, nucleoli
T-F– hyperplasia differs from carcinoma because invasion of the endometrial stroma occurs without invasion of the myometrium?
False- invasion does NOT occur in either
The spectrum of changes in the endometrium hyperplasia are due to what? what are they treated with?
- unopposed estrogen stimulation
2. progesterone
Where are endogenous hormones converted to estrone?
in peripheral fat
more fat= more estrogens
Why do PCOS have increased risk of adenocarcinoma?
do not ovulate regularly and thus have prolonged estrogen stimulus
In estrogen therapy for osteoporosis, what else needs to be administered?
progesterone in women who still have a uterus
